Homestead_BrittinghamCLAIM FOR HOMESTEAD PROPERTY TAX FORM ^ YEAR
CREDIT /STANDARD DEDUCTION C1
., State Form 5473 (R215 -92) ]`'ri'{�(�(� °�"
INSTRUCTIONS: See reverse side for tiling instructions. MAY
CERTI ATION STATEMENT
e11''pITOR -'
®) r "ty311'df on the 1st day of March, 19
I (we) occupied as our principal place of residence the following described real property for whid03 Homestead Property Tax Credit is hereby claimed:
III 1 (We) owned ❑ Are buying under contract
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
CONTRACT RECORDED
If buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
- PROPERTY DESCRIPTION
County -
Township
Wreby certify the above statements are true, correct and complete.
Taxing district (citI4 town, township)
PaOce6umber
Legal descri ro
GYl
If any portion of the residential structure or the land not exceeding one (1) acre t
of the property utilized to produce income.
.immediately surrounds that structure is used to pr uce income, describe the use and portion
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township
County Township
Wreby certify the above statements are true, correct and complete.
r cla am
Addre< (nu ben and sbeef. city, staA te. ZIP code)
(1)
trr_i Co
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Valuation or $2.000
$
Other land
(2)
Date signed Q
Total land (line I plus line 2)
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (fine .3 pirs fine/)
(6)
1 hereby certify the above is true, correct, and
r- �plete. ,
Signature of Assessor
Date signed
ling action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 112 Homestead
Valuation or $2.000
$
Signa/u,y�e Q�I Ai dit�a, y\�
Date signed Q
MATE FORM 53N.IRE/YNI TREASURE,roam 11A'
VPWWFO BY 51 QE BOARD OF NTPENTS_VN PLFSCIUBW BY THE OrPM1Mf`IT OF EIX'AE GOVERNMENT FINANCE r I.1 r.l
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N Main c
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than net for homestead fraud.homestead fraud causes higher tax bills for all:therefore.
• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recene the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filins. this information will he kept confidential and ran only he accessed by authorized county officials_The Dqunm-rn of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
. PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Bririingham, Charles/Stacy
RI Box 83 A \tJ'�/
_ Francisco IN 47649`
_ __ _ _ —_1041_ __ _ _ __ ____ _ _ ___ _ _- _
Charles/Stacy Brittingham
8376 E 500 N State Parcel Number Legal Description
Francisco IN 47649-9250
1r1rr11rrt1t11rrl1rt 11t1rtlrltrrtltlt ltltllrtt(rt tltI( III 26-06-16-200-002.749-017 C009-02-1 D249-00 PTE NE 16191.92 AC
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
ig Address(number rind street,city,sat-;and ZIP code)- — - ---❑ Saute as propertry ud ms -- - — —
gn7 (o SOD N 1-ro-nc: scv;Jnl 1/761/9
Spouse First Middle Last
S`f.....C 1 2 3r`t+4 : i , .
Mailing Address(Number and street,city,state.and ZIP code) ❑ Same as property addicts
$3, 6 £ 53orJ anc; sco �i'n . L/76Vi
PART 3:CERTIFICATION
Each undersigned certifies,under penalty of perjury',that the above and foregoing information is true and correct and that he or she is eligible to
receive the homestead standard deduction on this property. Each undersigned also understands that,by claiming additional homestead deductions
unlaOLLg wfullyhhe or she may be liable for back taxes and substantial financial penalties.
g `, Lam- Date /o
PART 4: ADDITIONAL INFORMATION
• U IV